Augmented Reality in Hepatic Surgery: Evaluating its Efficacy and Safety

A new systematic review and meta-analysis shows augmented reality–guided hepatic resection reduces perioperative blood loss and transfusion requirements compared with conventional approaches, offering timely evidence that could alter intraoperative decision-making for hepatic surgeons.

The pooled analysis found a mean reduction in blood loss of 75.9 mL and a lower transfusion rate (risk ratio 0.47). This numeric hemostatic advantage—linked to improved intraoperative visualization—supports more targeted hemostasis and may simplify control of bleeding in challenging resections.

For oncologic outcomes, the pooled risk ratio for recurrence was 0.52, indicating a lower recurrence rate in AR-guided cases; pooled data did not show a robust difference in margin status. The signal for improved recurrence suggests potential downstream oncologic durability, but margin effects remain uncertain.

No significant differences emerged in operative time, overall Clavien–Dindo complication class, post-resection liver failure, or length of stay, and AR-related complication rates were not increased in available comparisons. In short, AR improved select perioperative metrics while several standard outcomes remained unchanged.

Operational barriers persisted across studies: variable registration accuracy, limited intraoperative tracking fidelity, heterogeneous workflow integration, a material learning curve, and equipment footprint. Heterogeneity in AR platforms limits generalizability despite consistent pooled signals; standardized protocols, prospective registries, and training-focused studies are therefore recommended to confirm real-world impact.